Biomedical subjects

D Nagle

Publications and source records attributed to D Nagle.

21 records · Page 2Linked to original sources

PubMed1983

Non-cardiac surgery in patients with prior myocardial revascularization.

Patients who had undergone aorto-coronary bypass grafts (ACBG) were assessed for the incidence of cardiac complications in the postoperative period following subsequent non-cardiac surgery. One hundred and twenty-one patients had 13 complications (11 per cent). A significantly higher risk of cardiac complications (27 per cent) was found in patients undergoing non-cardiac procedures in the first month after ACBG. This remained higher (17 per cent) until the sixth month following ACBG. Significant factors which increased the risk of cardiac complications in the postoperative period included preoperative congestive heart failure (33 per cent), cardiac risk index score classification of III or IV (37 per cent), surgery on major vessels, and surgery necessitated because of a complication of the ACBG itself (17 per cent). No correlation was found between cardiac complication rates and recurrent angina, hypertension, the use of beta-blockers or digoxin, or anaesthetic technique. It is suggested that all but emergency surgery should be postponed in the first month following ACBG, and elective surgery be delayed for up to six months.

Adult↗

PubMed1976

Piriform syndrome.

Among a variety of deep muscle trigger points, the piriform muscle trigger point is selected for individual scrutiny. This seems fully justified by the great potential for confusing this entity with discogenic disease and consequently having unnecessary surgical procedures carried out.The diagnosis can be made from findings on simple physical diagnostic tests and an appropriate history. Low back and hip pain with pain radiating down the back of the leg should suggest piriform syndrome as part of the differential diagnosis. This is especially true if a female patient has complaint of dyspareunia. Pain and weakness on resisted abduction-external rotation of the thigh is a sign of piriform syndrome. This is confirmed by tenderness and reproduction of the patient's complaints by digital pressure over the belly of the piriform muscle, completing the diagnostic criteria. Local injection of the muscle belly is curative. There are no laboratory or x-ray findings leading to a diagnosis.

Back Pain↗

PubMed1975

A general method for the introduction of enzymes, by means of immunoglobulin-coated liposomes, into lysosomes of deficient cells.

Phagocytes of the smooth dogfish (Mustelus canis) contain no endogenous peroxidase within their lysosomes and constitute models for cells genetically deficient in lysosomal enzymes such as myeloperoxidase. We have obtained uptake of over 50% of exogenous horseradish peroxidase, provided the enzyme is exhibited to cells after incorporation into liposomes coated with heat-aggregated (62 degrees, 10 min), isologous IgM. Trapping of horseradish peroxidase (EC 1.11.1.7) by liposomes was established by chromatographic resolution (Sephadex G-200; Sepharose 2B and 4B) of free enzyme from that associated with liposomes; liposome-associated horseradish peroxidase, together with trapped markers of the aqueous compartment (glucose, CrO4 equals), were excluded, and free enzyme and markers were retained. Enzyme and marker trapping was not electrostatic, varied with the molar ratio of charged membrane components, and was reversed by detergent lysis (Triton X-100) of liposomes. Uptake at 30 degrees of aggregated IgM-coated liposomes containing trapped horseradish peroxidase exceeded that of free enzyme of 100-fold, and was more efficient than uptake of horseradish peroxidase presented in uncoated liposomes or in liposomes coated with native IgM. After phagocytosis, peroxidase-rich liposomes were localized exclusively in lysosomes of the phagocytes by ultrastructural histochemistry; the enzyme displayed over 50% latency to osmotic lysis. This method may prove to be of general use in the provision of exogenous enzymes to phagocytic cells genetically deficient in lysosomal hydrolases.

Animals↗